Table 3.
Neurological Sequelae Among Survivors Across Studies Reporting on the Effectiveness of Regimens to Treat Drug-Susceptible Tuberculous Meningitis in Children and Adolescents
| Study | Regimen | Definition of Neurological Outcomes |
Number Alive at End of Treatment |
Number (%) With Neurological Sequelae |
||
|---|---|---|---|---|---|---|
| Bang et al [13] | 2HRZES/1HRZE/5HRE | Severe or intermediate disability (not further specified) | 81 | Stage 1: 54 Stage 2: 19 Stage 3: 8 |
27 (33.3) Moderate: 21 (25.9) Severe: 6 (7.4) |
Stage 1: 11 (20.4) Stage 2: 10 (52.6) Stage 3: 6 (75.0) |
| van Toorn et al [14] | 6HRZEto | Mild sequelae: • mild intellectual impairment, • hemiparesis • impaired vision and/or hearing Severe sequelae: • severe intellectual impairment, • quadriparesis, • blindness and/or deafness. |
129 | Stage 1: 16 Stage 2: 68 Stage 3: 45 |
71 (55.0) Mild: 49 (38.0) Severe: 22 (17.1) |
Stage 1: 1 (6.3) Stage 2: 27 (39.7) Stage 3: 43 (95.6) |
| 9HRZEto | 12 | Stage 1: 2 Stage 2: 8 Stage 3: 2 |
6 (50.0) Mild: 3 (25.0) Severe: 3 (25.0) |
Stage 1: 1 (50.0) Stage 2: 3 (37.5) Stage 3: 2 (100) |
||
| van Well et al [15] | 6HRZEto | 435 | Stage 1: 13 Stage 2: 290 Stage 3: 132 |
294 (66.7) Mild: 217 (49.9) Severe: 77 (17.7) |
Stage 1: 2 (15.4) Stage 2: 182 (62.8) Stage 3: 110 (83.3) |
|
| Solomons et al (unpublished) | 6HRZEto | 35 |
Stage 1: 6 Stage 2: 15 Stage 3: 14 |
28 (80.0) | Stage 1: 3 (50.0) Stage 2: 13 (86.7) Stage 3: 12 (85.7) |
|
| Dhawan et al [16] | 2HRZE/10HR | Mild/moderate/severe disability, coma, or vegetative state |
91 | Not disaggregated by stage, but stage 3 was the strongest risk factor for poor neurological outcome | 29 (31.9) Mild: 17 (18.1) Moderate: 5 (5.5) Severe: 4 (4.4) Coma or vegetative state: 3 (3.3) |
|
| Gupta et al [17] | 2HRZE/10HR | Altered sensorium, cranial nerve palsy, extrapyramidal movements, focal neurological deficit, mental retardation, optic atrophy, and/or tone abnormalities |
109 | Not disaggregated by stage | 42 (38.5) No further details provided |
|
| Thee et al [12] | 2HRZE/10HR | Coma, paresis, spasticity, cranial nerve palsy, seizures, hydrocephalus, hypothalamic or pituitary dysfunction, developmental delay, impairment of speech, hearing, or vision | 12 | Stage 1: 2 Stage 2: 10 Stage 3: 0 |
6 (50.0) | Stage 1: 0 Stage 2: 6 (60.0) Stage 3: 0 |
Abbreviations: E, ethambutol; Eto, ethionamide; H, isoniazid; NR, not reported; R, rifampicin; S, streptomycin.